Acute Pulmonary Embolism (PE) is a critical cardiovascular emergency characterized by the sudden obstruction of a pulmonary artery, typically by a blood clot originating from deep vein thrombosis (DVT) in the lower limbs. As a leading cause of in-hospital mortality, its management requires rapid risk stratification and adherence to standardized clinical guidelines. Pathophysiology and Etiology
: Computed Tomographic Pulmonary Angiography ( CTPA ) is the gold standard for confirmation. Ventilation-perfusion ( Download Embolie pulmonaire aiguГ« pdf
: Tools such as the Wells Score or Geneva Score assess pre-test probability. The PERC (Pulmonary Embolism Rule-out Criteria) is used to safely exclude PE in low-risk patients without further testing. Acute Pulmonary Embolism (PE) is a critical cardiovascular
: For high-risk (hemodynamically unstable) patients, systemic thrombolysis (e.g., Alteplase) is recommended to rapidly dissolve the clot. Ventilation-perfusion ( : Tools such as the Wells
) scans are alternatives for patients with renal issues or contrast allergies. Management and Treatment
: Once a clot lodges in the pulmonary vascular bed, it increases pulmonary vascular resistance, which can lead to acute right ventricular (RV) failure and hemodynamic collapse.
: The mainstay for most patients. Low-molecular-weight heparin (LMWH) is often preferred over unfractionated heparin (UFH) for initial treatment. Long-term management typically involves Direct Oral Anticoagulants (DOACs) like apixaban or rivaroxaban.